Adjustment to chronic heart failure : a biopsychosocial approach

The prevalence of Chronic Heart Failure (CHF) is increasing and recent studies outside of the UK suggest that psychological adjustment to this disease can be poor. The present study aimed to: - 1) Determine the prevalence of anxiety and depression disorders in a UK sample. 2) Explore the validity of the Hospital Anxiety and Depression Scale (HADS) against a structured clinical interview (SCID-I). 3) Identify the predictors of depression and anxiety. 4) Identify the predictors of hospitalisation and mortality. PARTICIPANTS AND MEmODS - A postal survey of 118 patients from a specialist CHF unit in the UK was followed by a face-to-face interview with 100 patients. Measures used included those of depression, anxiety, social support, cognition, biomedical status and previous physical and mental health history. RESULTS - Prevalence rates of anxiety ranged from 18.4 - 42.3% and depression ranged from 15.3 - 37.8% dependent on the type of measure used (HADS or SCID-I). The HADS had adequate discriminatory ability. Both psychosocial and biomedical predictors of anxiety and depression were identified, although these differed depending on the scale used as the dependent variable. Associations were found between depression, anxiety and hospitalisations although these were not significantly strong to survive in the regression analysis. CONCLUSIONS - Prevalence rates of anxiety and depression are high in this population. The results were discussed according to their contribution to theory, clinical practice and future biopsychosocial research with this population